Oliver Sacks, distinguished neurologist and best-selling author, is having trouble deciding what to have for lunch. The doctor strokes his bushy beard and hems and haws as he looks over the room-service menu of the Toronto hotel where he is staying while promoting his latest book, An Anthropologist on Mars. Rather dejectedly, he settles for a club sandwich. But the thought process - looking for the right thing to satisfy his craving - clearly fascinates him. Without prompting, he describes his reaction when, almost 20 years ago, he was laid up in a London hospital with a leg injury and a friend brought him a smoked trout. "It not only put me into ecstasy," Sacks recalls, "but I also had the feeling that really much of my misery in the hospital was due to an unconscious yearning for a smoked trout. Indeed, perhaps my whole life was accreted about this previously unrecognized yearning." He pauses - another hem and a haw - and adds: "I felt the same with regard to [Danish philosopher Soren] Kierkegaard when I read him for the first time." His eyes suddenly light up. "There must be something about hitting the spot," he beams. "When the spot is hit, there's this strange feeling that it was waiting to be hit."
Sacks is not being flip. An immensely well-read and soft-spoken man, the 61-year-old New York City-based neurologist likes to quote E. M. Forster's axiom, "Only connect." And it is possible to see his medical and writing career as an ongoing attempt to do just that - with his patients, with his readers and, perhaps, with himself. In books such as Awakenings (1974) - made into a 1990 movie starring Robin Williams as Sacks - The Man Who Mistook His Wife for a Hat (1986) and now An Anthropologist on Mars (Knopf), he has revived the case study as a popular literary form. He skilfully bridges the chasm between diagnosis and literature, blending sometimes highly clinical observations of neurological disorders with a profound thoughtfulness for the person affected. The search for the "spot," the vital, if mysterious, connection of doctor and patient, mind and body, is central to his work.
And An Anthropologist on Mars is his best book to date. In it, Sacks relates seven case studies, all of them previously published in The New York Review of Books or The New Yorker. With unfailing empathy and a seemingly encyclopedic knowledge of the latest neurological theory, he describes the struggles and triumphs of a New York painter who suddenly becomes completely color-blind, or achromatopsic; a onetime hippie whose memory ends in 1969; a British Columbia surgeon with Tourette's syndrome, which can cause its sufferers to move and curse unpredictably; a man whose sight is restored after 40 years of blindness, but who still cannot see; an artist who paints only visions of the Italian village he left as a young man 50 years ago; a British autistic teenager who creates stunning architectural drawings from memory; and an intellectually gifted scholar and engineer whose autism prevents her from engaging in complex human emotions such as love. An Anthropologist on Mars is a neurological travel book, a geography not only of the mind, but of the human spirit.
Perhaps one of the reasons for Sacks's facility with neurological "abnormality" - a term he uses infrequently and reluctantly to describe the people he writes about - is the fact that he is such a singular character himself. He is notoriously shy. A bachelor, he lives alone in a house on New York's City Island. He says he is celibate. Yet he is given to odd passions: his love of ferns and of swimming, for instance, verge on the fanatical. In person, he seems almost overwhelmingly diffident, a demeanor that belies his imposing frame, all six-feet and 200-plus pounds of it. And on the subject of his authorial career, he is self-deprecating. "I don't actually know what I'm doing," he says. "And I prefer not to know what I'm doing. I even feel it may be dangerous."
Still, storytelling and medicine are both part of his family legacy. His father, Samuel, and mother, Elsie, were both physicians - as are his three older brothers. While growing up in prewar London, Sacks quickly learned the narrative approach to medicine from his parents. "Telling is in my blood," he says. "It was so with my parents, who liked telling their medical experiences - and to all and sundry, in a rather incontinent way."
As a child, Sacks recalls, he was fascinated by travel literature, including Charles Darwin's descriptions of the Galapagos Islands. And after receiving his medical training at Oxford in 1958, he decided to write about his own wanderings. One of his first books was a travel journal of Canada, titled Canada 1960. "I spent several months here, sort of between the past and the future, not quite knowing which way life would go," he recalls.
Life took him to the United States, where he studied at the University of California in Los Angeles before becoming an instructor in neurology at Albert Einstein College of Medicine in New York City (he is now a professor of clinical neurology there). But travel remains his passion - he recently visited the so-called Island of the Color-blind, Pingelap, where genetic achromatopsia is rampant. "I also regard neurology itself as a form of travelling, both for the person and for the explorer," he says. "These are other lands, the lands of achromatopsia, autism, migraine, with their own customs and assumptions."
In An Anthropologist on Mars, the traveller Sacks plays a vital role in the seven stories. He is at times heartwarmingly subjective - as when he describes how flying in a plane piloted by the surgeon with Tourette's syndrome made him somewhat anxious - and given to flights of philosophical fancy. "Could one be an artist without having a 'self'?" he wonders in Prodigies, about the precocious autistic artist Stephen Wiltshire. And bit by bit, he reveals his own fascination - perhaps even identification - with his subjects. At the end of his story about Temple Grandin, an autistic professor of animal science at Colorado State University whose intellectual prowess more than makes up for her emotional deficit, Sacks writes: "I said, 'I'm going to hug you. I hope you don't mind.' I hugged her - and (I think) she hugged me back."
Sacks's unique strength as a writer is that he tries to get inside not only his subjects' heads, but also their lives. "Something which was important to me as a medical student," he recalls, "was an old man, dying of uremia and delirious, about whom the doctors said, 'Don't waste your time with him - it's all nonsense. ' But I listened to him by the hour and found it fascinating. I had the feeling of a whole life in figures and landscapes. It was like being privy to a dream." With endless curiosity, Sacks does the same thing in Anthropologist - listening to the disorder and to the person.
Not surprisingly, he is ambivalent about the current rage for pharmaceutical solutions to complex psychological problems. He freely admits experimenting with drugs in the 1960s. "I'm glad I did, and glad I stopped, and glad I didn't kill myself," he says. On the other hand, he adds, "I'm the only person I know not on Prozac. And God knows I need it more than any of them." Why? "I get down, I get melancholy. I think how worthless and meaningless it all is." Sacks sees an analyst twice a week, but has said he is unlikely to turn to Prozac. "I think it's a very important antidepressant for people who are unhappy," he acknowledges. "But the cosmetic use, or the notion that we could all be reconfigured and happier and this and that - I think this may bypass some of the crucial experiences of living, and the sufferings and complexities that go with it."
Sacks does his thinking in swimming pools. An avid swimmer - and competitive weightlifter - in university, he now gets wet twice a day, for as much as two hours in total. "I feel I belong in the water - I feel we all belong in the water," he says. "It's a rather solitary activity, in a way. Even if there are two or three people in the same lane, you're always independent from them." He does much of his reading, meanwhile, in the bathtub, where he often dozes off. "All my paperbacks," he confesses, "have been in the bath."
Sacks's enthusiasms and eccentricities are famous. He is a huge fan of Star Trek: The Next Generation, and recently visited the set in Los Angeles. "Oh, yes, I have a picture of myself with [the android character] Data," he gushes. Typically, the memory leads him off on a tangent. "I thought that seeing the gimcrack scenery of the set would spoil the illusion for me, but it didn't. I'm completely taken in by theatrical illusion. With the film Kind Hearts and Coronets, people asked me, 'Did you recognize Alec Guinness in all eight roles? ' And I said, 'No, I didn't recognize him in a single one! ' " Sacks lets out a roaring laugh. "I'm the ideal theatregoer, because I'm an idiot."
There is something childlike, too, about Sacks's concern for living things. Like ferns, for instance. He rather dislikes flowering plants - "modern and vulgar and new and trendy, and they've only been around 100 million years." But to him, ferns are "paradisal - I think of the Garden of Eden as looking somewhat like the Australian or New Zealand forest, with its tree ferns. I like the idea of this individual, unashamed, gallant, sensible group of plants that developed in its own way - they're really great survivors." He has a similar passion for cephalopods - the invertebrate family that includes squids, cuttlefish and octopuses, several of which he has kept as a hobby. "You don't have to have a backbone," he says, "to be interesting and intelligent."
Sacks speaks with admiration of the subjects in Anthropologist, all of whom he regards as friends. But he seems particularly fascinated with Mr. I., the New York painter struck with color-blindness. Faced with the prospect of a cure - I.'s color-blindness is linked to a dysfunction of a small and little-understood part of the brain known as V4 - the artist refused. He had come to terms with his new way of seeing, preferring black and white to color.
As he gazes at a vase of red and yellow roses sitting nearby, luminous in the sunlight filtering through the hotel-room window, Sacks utters a characteristic "Umm," then adds: "I find myself looking at the color of these flowers, and imagining a blood vessel suddenly pinching off in V4, the flowers greying out." He pauses. "I think what one does have seems so much more precious when it seems more precarious."
Maclean's March 13, 1995